Indicators for Psychosocial Programs

1
Indicators for Psychosocial Programs

• Leslie Snider, MD, MPH
• REPSSI
• Tulane University SPHTM

2
ME of Psychosocial Programs

• New field with few models
• Work includes global, national and program-level
  indicator development
• Two illustrative studies (Horizons)
• Zimbabwe impact of psychosocial programs on
  well-being of adolescents
• Rwanda impact of adult mentorship program on
  CHH, younger siblings and mentors

3
What is Psychosocial?

• Achieve a better understanding of what
  psychosocial programs intend to do clear
  objectives help to demystify the concept
• Not a separate sector interwoven with all other
  programs/services that promote childrens healthy
  development, and shore up their resilience in
  face of adversity
• Good enough mothering

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Objectives

• Psychosocial programs intend to provide
  culturally-appropriate care, support, nurturance
  and guidance for children and adolescents at
  different stages of their development
• Help to coordinate services to meet the array of
  childrens well-being needs, in a sensitive and
  caring way
• Time spent with a child in a caring relationship,
  availability of adult or mentor to the child

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Types of Indicators

• Emotional health of child is expressed in various
  ways
• Physical health
• Behavior
• Self-perception and self-esteem
• Functioning
• Proxy indicators include general health and
  nutritional status (is child fed, clothed,
  clean?), living conditions, school attendance
  and performance (matriculation)

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Emotional, Social, BehavioralIndicators

• Cross-culturally determined
• Include mood (self-perception), self-esteem,
  confidence, behavior (including risk behavior),
  functioning according to age and developmental
  stage, cognitive aspects (cognitive capacity and
  future outlook, hopefulness), and spirituality

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Well-Being Domains

• Social connectedness
• Psychological health, including self-perception
  (mood and esteem), cognitive and behavioral
  aspects
• General health and well-being
• Functioning in relevant roles

8
Some Challenges to Psychosocial Indicator
Development

• Cross-cultural contexts the experience,
  expression and recognition of emotional distress
  is rooted in culture
• Establishing indicators for children and
  adolescents at different ages and developmental
  stages
• Gender considerations

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Use of Standardized Measures

• Standardized psychological scales may be useful,
  but require adaptation and validation (Paul
  Boltons work)
• Zim study physical symptoms had other meaning
• Instruments found to be useful in other contexts
  CBCL, GHQ, MOS
• Even if using standardized scales, qualitative
  methods essential to get at the priorities and
  terms in children and youths own words

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Take Home Messages

• Psychosocial programs provide care, support,
  nurturance and guidance to children and
  adolescents through supportive relationships.
  They also coordinate the array of services to
  meet well-being needs of children. Like a
  mother.
• Useful indicators include proxy measures (general
  health, nutrition, etc.) and emotional, social
  and behavioral measures
• Qualitative methods are most useful in
  determining local terms for emotional distress
  and priorities for psychosocial health and
  interventions